South Bay Surgical and Spine Institute

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTH BAY SURGICAL AND SPINE INSTITUTE

Practice address

4300 Long Beach Blvd Ste 150
Long Beach, CA 90807-2016

Phone

(562) 728-0230

Fax

(562) 728-0237

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shelly Rosekelly

Title

Manager

Phone

(310) 740-4933

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1851508667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 LONG BEACH BLVD STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072016",
            "telephone_number": "562-728-0230",
            "fax_number": "562-728-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONG BEACH BLVD STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072016",
            "telephone_number": "562-728-0230",
            "fax_number": "562-728-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY SURGICAL AND SPINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "ROSEKELLY",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-740-4933"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "05C0001865",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Kawakami Soubra, NURSE PRACTITIONER
• Christen Soucy, FNP
• Rachael J. Sousa, M.A., MSW
• South Bay Psychiatric Group, a Medical Corporation
• South Bay Skin and Wound Care
• South Coast Health Care Corp
• South Medical Clinic
• South Medical Group
• Lara Lynn South, PHD
• Bali Southam

• Ambulatory Surgical Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.